Hair loss from chemotherapy or radiation therapy isn't just upsetting; it can be a nuisance and uncomfortable to boot. Here are some suggestions to keep the person you're caring for as calm and comfortable as possible while dealing with this annoying side effect.
Take special care of the scalp
Chemotherapy agents damage the hair follicles and wreak havoc on the balance of oils in the skin underneath the hair as well. "During chemo, the scalp gets really dry and flaky, which can lead to itching," says Terry Anders, a registered nurse and clinical educator at the Mark H. Zangmeister Cancer Center in Columbus, Ohio. "I've found that rubbing the scalp every day with a perfume-free lotion such as Eucerin helps soothe, moisturize, and prevent itching." Anders also recommends continuing to wash the scalp with gentle shampoo, even if there's no hair present, to condition it and help prevent itching. "Some patients wash their scalp with regular body soap, but that can be very irritating."
Afterward, Anders says, have the person pat his head gently with a soft towel (he should avoid rubbing, squeezing, or twisting with the towel).
Shaving often helps
Another cause of sensitivity or itchiness is new hair growing in. Some cancer patients find that shaving their heads can prevent this irritation. Patients with sensitive scalps may find pillowcases made from synthetic fibers irritating, so switch them to all cotton or all linen if the person has been using a poly blend.
Protect the head from cold
Without as much hair covering the head, it's natural for cancer patients to feel cold more quickly because heat escapes through the head. And cold can lead to increased sensitivity as well. Suggest that he wear a hat and scarf when going outside and even in the house if it's at all cool or drafty.
Treat hair gently
There's nothing a patient can do to prevent hair loss, but being extremely gentle with the hair can reduce the amount that falls out at any one time. Advise the person you're caring for to brush his hair as little as possible and to use the softest brush available. When combing, use only a wide-tooth comb and go easy on tangles. If the patient is female, take a break from hot rollers or other styling aids, if possible, and avoid elastic ponytail holders and other hairstyles that pull on the hair. If she normally gets permanents, suggest that she revert to straight hair during chemotherapy, as heat and chemicals can cause hair to fall out. It can help to wear a hairnet at night, and some people suggest sleeping on a satin pillowcase or one with a very smooth weave to prevent the hair from catching and pulling. As new hair begins to grow in, it will be brittle and delicate, so it must be treated gently as well.
Be vigilant about sun protection
Sunburn is a real danger when hair loss leaves the scalp newly exposed. Even thinning hair creates more vulnerability to sunburn, which in turn can cause more itchiness, flakiness, and dry skin. Remind the person to apply sunscreen whenever he's going outside, even to areas where there's still thinning hair, or better yet, a hat.
Beyond the practical concerns about hair loss from chemo or radiation treatments, losing hair is often a highly emotionally charged issue for the patient.
Be sensitive to body image issues that come with loss of hair
This is a subject that isn't talked about much, and it can come as a shock to cancer patients when they lose underarm, body, and pubic hair. "It can be a major body image issue," says Anders. "For men especially, losing body and pubic hair can bring a whole new sexual dynamic that they may be very self-conscious about." You may not feel comfortable bringing this up with the person you're caring for unless you have an unusually open relationship, but be sensitive to any embarrassment he feels about it when bathing or dressing.
If he loses underarm hair, the skin there can become irritated and sensitive. Suggest that he stop using his regular deodorant and switch to baby powder or an all-natural deodorant that doesn't contain perfume or dyes. If underarm skin becomes dry or flaky, use a perfume-free lotion like Eucerin to moisturize and soothe the skin.
Losing eyelashes and brows can also be upsetting
If eyebrows and eyelashes start to fall out, it can be particularly upsetting because it changes the look of someone's face so noticeably. Many cancer patients say they hate looking in the mirror and not recognizing themselves, says Laura Beemiller, a social worker at the Zangmeister Cancer Center. During chemo, the patient may be able to minimize eyebrow and eyelash loss by being gentle with these areas and trying not to rub them. But a woman may want to use makeup to enhance her eyebrows and eyelashes as well. Help her choose eyebrow pencils and eyeliners that are the same color as her natural color or a shade lighter. (Going too dark can look strange, especially against pale skin.) False, stick-on eyebrows are also available from wig shops and specialty supply stores, or you can find them online by searching for false eyebrows or visiting She Maketh Herself Coverings. They require a special adhesive to stick them on and an adhesive remover to remove them.
Another option is a tattooing technique available in many spas and beauty salons, in which color is semi-permanently inked into the skin. Tattooing does hurt, so it's not a good idea for someone who's already dealing with pain.
Relieve discomfort and stress with a gentle scalp massage
Lightly massaging the person's scalp brings blood flow to the skin and hair follicles, possibly even stimulating hair growth, and helps relieve irritation. It also just feels good and is soothing. If you'd like, you can rub in almond or olive oil or another natural oil, which is a good way to calm and moisturize sensitive, irritated skin.